Laparoscopy, also referred to as keyhole surgery, is a relatively recent minimal invasive surgical technique in which instruments such as miniature lights, cameras and surgical tools are inserted into an insufflated abdominal cavity through a small incision or puncture wound and manipulated externally with the aid of an endoscope and TV monitor. Considerable skill and experience is generally required to position the instruments spatially relative to internal organs viewed on a two-dimensional monitor.
A modified laparoscopic technique has evolved which is referred to as hand-assisted minimally invasive surgery in which one hand of the surgeon has access to the cavity while maintaining pneumoperitoneum. This technique, such as described in U.S. Pat. No. 5,640,977 to Patrick F. Leahy, et al. is now an alternative procedure of choice where conditions allow. For the patient, trauma is minimized, the risk of damage to the immune system is reduced, and healing time and length of stay in hospital are both shortened because only a relatively small additional incision is required just sufficient for admitting the surgeon's hand. For the surgeon, less training is required because the presence of his/her hand in the cavity allows palpation of internal organs, biophysical feedback, and easier manipulation of various instruments from within the cavity while viewing the TV monitor. However, during a surgical procedure more than one surgical tool may be required but is too difficult to hold onto while another is manipulated within the cavity. Instead, the surgeon must withdraw the hand from the cavity in order to change to another tool, consequently interrupting the procedure and disturbing pneumoperitoneum.